I wish I could say that learning to breastfeed was easy for me, but it wasn’t. I knew all of the reasons to breastfeed my daughter. I researched breastfeeding and took breastfeeding classes, prior to her birth. I thought I was prepared. I wasn’t. It took a lot of work, hard emotional and physical work, in order to establish our breastfeeding. Standing on the other side, with a happily thriving, exclusively breastfed baby, I still don’t know how I did it.
Our breastfeeding work began at the moment of Nora’s birth, when she was placed naked on my chest. I was hoping to see her do the cool crawl toward her food source, but she only rooted around in the general area. After a few moments, the nurses helped me place on her my nipple and she latched on. Phew. Breastfeeding accomplished. Just in case, I requested a visit from a lactation consultant, just to make sure that I was doing everything right.
During the evening, the nurses encouraged us to chart each and every feeding, as well as each bowel movement and urination. (Welcome to the thrilling world of parenting, where we are obsessed with our child’s output.) We were also instructed to wake her every 2-3 hours for a feeding. This was easy enough, since I was still so high on adrenaline from the birth that I wasn’t sleeping at all.
The difficulty came when my husband and I tried to wake Nora for her feedings. She slept through almost anything we tried: tickling her feet, changing her diaper, undressing her. When she did try to feed, it was almost impossible to get her to latch. If she latched, she wouldn’t suck. I took deep breaths, reminded myself that newborns have teeny tiny stomachs, and waited for our visit from the lactation consultant.
Our first visit from the lactation consultant went well. She gave me some tips on positioning, as well as ways to wake Nora up from her deep sleeps. We added bouncing and jackknifing her body to our repetoire. She also encouraged me to pump after every feeding, to make sure that my milk supply would come in. Anything that I pumped, which was a scant amount of colostrum at this point, I fed to her on my finger. Any little bit that she dribbled out of her mouth felt like a loss.
On the next day, the hospital internist visited Nora for her first check up. He noticed that she was pretty yellow. She tested borderline for jaundice. He asked how her feeding was going. I explained that she slept through most of them and he remarked at how lucky I was to have a baby that sleeps well. Later that same day, the lactation consultant returned and I explained that feeding was still slow going. She labeled our baby as “sleepy” and encouraged me to begin supplementing with formula immediately. She was concerned that if Nora didn’t consume enough calories, she would sleep more and I would not be able to establish breastfeeding. The consultant gave us a chart which indicated how much formula to feed our baby, based on how long she successfully fed and how old she was.
As soon as the consultant prescribed formula, I felt like I had failed. I had read so much about breast milk versus formula and I knew that breast milk was the best possible food for Nora. Formula was barely food, in my opinion. Aaron and I discussed it and we decided that we would rather temporarily feed our daughter a less than perfect food, so that we could eventually learn how to feed her the optimal food. So, I dutifully took the consultant’s chart and began supplementing. Aaron and I fed Nora her formula by inserting our clean pinkie finger in her mouth, along with an eye dropper full of formula. We painstakingly dribbled drops of formula into her mouth this way, after giving her the quarter teaspoon of colostrum that I pumped. I also continued to try to get Nora to latch, which was feeling less and less successful.
After we returned home, I made an appointment with a different lactation consultant at the hospital. I continued, with every feeding, to first try to breast feed, then feed Nora any expressed colostrum I had on hand, then formula. After all that, I would pump for 15 minutes. Then, I would clean the pump parts and try to sleep. Feedings took at least an hour each time and I had to feed Nora every 2 to 3 hours. At night, if I slept at all, it was in forty-five minutes bursts. During the day, I barely napped, because there was too much to do to settle our home.
I met with the second lactation consultant when Nora was three days old and she observed my breastfeeding skills. I also brought with me the contents of my bottle, because it looked like my colostrum was slowly turning into milk. (It was, a full eighth of an ounce I had pumped that morning.) She noticed that when Nora latched, that she stopped sucking. The consultant said she was waiting for me to turn on the stream. This was so difficult for me to hear, because I felt like I had no stream yet. I had a dribble, if anything. What I didn’t know then, that I do know now, is that stress inhibits a letdown. As I became more stressed about turning on the stream, I was less likely to be successful.
The consultant recommended that I use a supplementary nursing system. Basically, it’s a series of tubes that you tape to your breasts and nipples, connected to a reservoir filled with expressed milk. Once she latched on, I was supposed to “turn on the stream” by unhooking the tubes connected to the reservoir. In order to make this work, I needed four hands, so I enlisted my husband and mother-in-law to help. Each time we used it, Nora would latch onto the tube, rather than my nipple. If she turned her head slightly, my expressed milk would leak all over her face and chest. It was painful to watch the little amount of milk that I expressed splash anywhere but her mouth. The second time I used the system, I was so tired and frustrated that I began hysterically bawling. This was not the solution for me.
I ditched the supplementary nursing system and returned to pumping and supplementing with formula. During her first week, we needed to supplement with more and more formula as she grew older. We quickly moved from using an eye dropper for formula to using a rubber nipple hooked on the formula bottle. It was devastating to see Nora latch so easily onto that fake nipple. She looked so content drinking the formula. Since my milk was slowly coming in and Nora was still sleepy during feedings, I felt that I was on the losing side of the battle. Formula, my enemy, was winning.
My first turning point came with my first post-partum visit with my doula, Kathy. She watched us breastfeed and for the first time, Nora latched easily and stayed on my breast for several minutes. Kathy gave me a few pointers on positioning, complimented the work that we were doing, and asked about Nora’s behavior. I explained that she was sleepy during feedings and Kathy told me that it was due to Nora’s jaundice. Apparently, jaundice makes a baby sleepy, which no one else had told me. (After seeing two pediatricians and two lactation consultants, I was pretty upset about this oversight.) She recommended that I make sure Nora got a lot of sunlight and to keep practicing breastfeeding.
My second turning point came when we began to run out of the free formula from the hospital. Aaron asked his mother to purchase more formula and she bought three boxes. I told myself that I didn’t want to open those boxes, that I had to learn how to breastfeed before we finished the last bottle of hospital formula. I couldn’t go down the road of dependency to formula, because it was so convenient and easy, but I also couldn’t starve my child. I had to figure this out.
We slowly made progress. Each morning, I told Nora that we were going to practice breastfeeding all day. And we did. I kept myself calm during the feedings, because they were just practice. Each feeding, Nora got a little bit better at staying on my breast and swallowing milk. I got to feed her less and less formula. By her third week of life, we had stopped using formula all together. We had one bottle of formula left from the hospital. The three boxes remained unopened.
At this point, we’ve been exclusively breastfeeding for six and a half weeks and I am still learning. I know now that breastfeeding, like a lot of things in parenting, isn’t an endpoint. It’s a process that I continuously engage in with my family. I expect that we will encounter obstacles throughout our breastfeeding practice, especially as I return to work and introduce solid foods. But I have established an important, if hard won, foundation with my daughter, one which I will always value.